8-Year-Old in West Texas Died From Hospital-acquired Pneumonia, Medical Records Show
She didn’t die from measles. They just want you to think she did.
This article originally appeared on The Defender and was republished with permission.
Guest post by Suzanne Burdick, Ph.D.
Doctors who reviewed 8-year-old Daisy Hildebrand’s medical records disputed the Texas health authorities’ statement that she died from “measles pulmonary failure.” They said medical records show she died from acute respiratory distress “secondary to hospital-acquired pneumonia,” which she likely developed during a previous hospital stay.
An 8-year-old West Texas child died April 3 of acute respiratory distress syndrome (ARDS) due to hospital-acquired pneumonia, according to Dr. Pierre Kory, who analyzed the child’s medical records.
Daisy Hildebrand died at University Medical Center (UMC) Children’s Hospital in Lubbock, Texas, at 1:50 a.m., according to Brian Hooker, Ph.D., Children’s Health Defense (CHD) chief scientific officer, who also reviewed the records.
On April 6, the Texas Department of State Health Services (DSHS) issued a news release calling her death the “second death in [the West Texas] measles outbreak” and attributing the death to “measles pulmonary failure.”
Kory — who has extensive experience in pulmonary and critical care medicine — told The Defender that the child’s medical records showed she died from “ARDS secondary to hospital-acquired pneumonia,” which he said she likely developed during a previous hospital stay.
Kory said:
“The causative organism was a highly antibiotic-resistant E. coli (‘superbug’), which she contracted during the first hospital ICU [intensive care unit] stay.
“This went largely unrecognized and poorly treated during the second hospital stay because they began to ‘tunnel in’ by blaming measles for her worsening pneumonia and repeatedly writing in the chart that she was unvaccinated.
“Of the eight days she spent in the second hospital [visit], the child was given antibiotics for only four days. Not until two days before her death did the thought of a ‘possible hospital-acquired infection’ creep into the records. The bug was utterly resistant to the antibiotics they put her on.”
If the hospital staff had followed the adult hospital-acquired pneumonia (HAP) guidelines, the child “would have been placed on the correct antibiotic,” Kory said. “She had numerous risk factors for HAP, including previous antibiotics, previous ICU stay, being immunosuppressed and really sick.”
In an email, Kory explained:
“In their [the doctors’] defense, and I was shocked to learn this, THERE ARE NO PEDIATRIC HAP GUIDELINES, so antibiotic choices are not established; thus, technically, they did not veer from any guidelines because there are none for kids.
“The American Academy of Pediatrics should be scolded for this. The first adult guidelines came out in 2005. Here we are 20 years later, and there are no pediatric ones?”
UMC medical records shed light on child’s illness and death
Soon after the child’s death, UMC released her medical records to the family.
In addition to sharing the records with Kory and Hooker, the child’s parents shared them with Dr. Ben Edwards, integrative medicine family practitioner in Lubbock, and Dr. Suzanne Humphries, co-author of “Dissolving Illusions: Disease, Vaccines, and the Forgotten History.”
Hooker — who spoke with the child’s parents — pointed out that the child’s illness and treatment history were complicated during the weeks leading up to her death.
For instance, before she was hospitalized at UMC, Daisy was admitted to Covenant Children’s Hospital — the same hospital where a 6-year-old girl died in February after developing pneumonia following a measles diagnosis.
However, the 8-year-old’s medical records all pertain to the care she received at UMC. Kory, Hooker, Edwards and Humphries were not able to review Covenant Children’s Hospital records.
The Defender asked Covenant Health’s Senior Media & Community Relations Manager Meredith Cunningham to comment on the care Daisy received at Covenant Children’s Hospital.
Cunningham said patient privacy laws prevent the hospital from sharing details on patient care.
The Defender also reached out to UMC Health System’s Vice President & Chief Experience Officer Aaron Davis for comment on Daisy’s UMC medical records but did not receive a response by the deadline.
However, in a statement provided to The Washington Post on April 6, Davis confirmed the child died at UMC.
According to Kory and Hooker, Daisy was admitted twice to UMC in March. Her first visit began March 21, when she was admitted to the emergency room (ER) with diagnoses of community-acquired pneumonia, a urinary tract infection and dehydration, Hooker said.
Kory said she was also diagnosed with hypoxia, or low blood oxygen levels.
At admittance to the hospital’s main pediatrics ward, staff noted the child had a prior diagnosis of mononucleosis from a positive test for Epstein-Barr virus that was done before she went to UMC. She also had a prior diagnosis of sepsis at admittance. However, she tested negative for sepsis at UMC.
On March 24, she tested positive for measles using a PCR test. “A rash was noted on the torso and face during this admission, but also oral thrush,” Kory said.
According to the Mayo Clinic, oral thrush occurs when the fungus Candida albicans builds up in the mouth. Kory said the child’s oral thrush was “worrisome because it is a sign of immunosuppression.”
The Mayo Clinic states:
“Although oral thrush can affect anyone, it’s more likely to occur in babies and older adults because they have lower immunity. It’s also more likely to occur in other people with weakened immune systems or certain health conditions or people who take certain medicines.
“Oral thrush is a minor problem if you’re healthy. But if you have a weakened immune system, symptoms may be more serious and harder to control.”
Later, she was transferred to the hospital’s ICU.
The hospital staff gave her antibiotics and oxygen to address her pneumonia and low blood oxygen. She began to improve. On March 24, she was sent home.
Child returns to UMC, put on steroids as antibiotics are halted
Three days later, on March 27, Daisy was readmitted to UMC after her parents brought her to the ER with a cough, fever of up to 104 degrees Fahrenheit and shortness of breath.
“The problems start here,” said Kory, referring to her treatment when she was admitted the second time to UMC.
“The admitting doctor’s diagnosis was ‘pneumonitis,’ and antibiotics were quickly stopped after admission,” Kory said.
The records suggest that the hospital staff assumed her pneumonitis, or lung inflammation, was due to a measles infection, Hooker said. Because measles is a virus, doctors presumably did not immediately consider the possibility that her lung inflammation may have been caused by a bacterial infection.
Kory gave a rundown of what occurred over the days leading up to the child’s death on April 3.
The doctors first put Daisy on “high-dose steroids” without putting her on “anti-infectives.”
According to Drugs.com, anti-infectives is a general term that describes “any medicine that is capable of inhibiting the spread of an infectious organism or by killing the infectious organism outright.”
Kory said the high-dose steroid might have been safe and beneficial if paired with appropriate anti-infectives, but prescribing steroids without anti-infectives was a “lousy idea.”
Kory, Hooker and Humphries all confirmed that the child did not at any point receive budesonide, a steroid used to relieve inflammation affecting the airways that has been successfully used to treat pneumonia following a measles infection.
The child’s father told Hooker the family requested budesonide treatments. Hospital staff told the family that the girl’s doctors were taking a different course of action by giving her intravenous steroids, so she didn’t need budesonide.
On days two, three and four of Daisy’s second stay at UMC, the staff continued to treat her based on the assumption that she had measles-pneumonia, caused by measles — “even though on day four, she decompensated in respiratory status,” Kory said.
On day four, the child’s white blood cell count (WBC) “shot up to 13 from 4.5, and then on day six, it went up to 27,” Kory said.
A classic measles-pneumonia has normal or low white blood cell count, Kory said. “It was wild that they ignored such a high white count. It is possible they dismissed it as a result of the steroids, but for a seasoned ICU doctor, I never attribute WBCs over 20 to steroids.”
‘They tried everything to oxygenate her, but all efforts failed’
On day six, staff intubated the girl and restarted her on antibiotics.
On day seven, staff “somewhat correctly broadened” the kind of antibiotic they were giving the child to include ceftazidime, Kory said. “However, the adult guidelines would have dictated imipenem, which the bug she died from was sensitive to.”
Sadly, the type of bacteria causing her pneumonia was resistant to ceftazidime, Kory said.
According to Kory’s analysis of the records, the child’s attending doctor wrote on the day before her death that she was experiencing “severe pulmonary sequela of measles infection around 3 weeks ago.”
The attending doctor added, “We are concerned that the true extent of her lung injury d/t [due to] measles is unknowable, and it may be an end-stage process given the span of illness and the fact she truly is an outlier.”
On day eight, Daisy died of refractory hypoxemia, meaning her arteries weren’t getting enough oxygen even though she was having oxygen pumped into her from a ventilator.
“They tried everything to oxygenate her, but all efforts failed, and the family asked for no CPR,” Kory said. “She was near death anyway; it was the right call.”
Hospital delayed sputum culture until it was too late
In an interview today on CHD.TV, Kory said it wasn’t until days into the child’s second stay at the hospital that the staff did what’s called a sputum culture to identify the specific bacteria, fungi or other germs in her lungs.
Kory said that waiting so long was a deviation from the standard of care.
“Anytime we admit someone to a hospital and we’re starting them on antibiotics — especially broad ones — you send cultures so that you can identify what the organism is so that you can then narrow and target the exact organism,” Kory said.
Hooker agreed. He told The Defender that while it may be true that the child had some residual viral pneumonia due to her measles infection, the “problem” was the bacterial pneumonia that she likely picked up during her first stay in the ICU.
Hooker criticized UMC staff for an “apparent lack of curiosity” about figuring out early on what types of pneumonia the girl had via a sputum culture.
He noted that the test results showing that the girl had E. coli bacteria in her lungs did not come back until 10 p.m. on April 2.
By that time, she was already on a ventilator. Less than four hours later, she was dead.
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Related articles in The Defender
Texas Reports 8-Year-Old Died of ‘Measles Pulmonary Failure,’ CHD Requests Medical Records
‘Medical Error’ Led to Death of 6-Year-Old Who Developed Pneumonia After Measles Diagnosis
Texas Reports Death of Child Who Tested Positive for Measles, But Releases Few Details
CHD.TV Exclusive: Parents of Child Who Died During Texas Measles Outbreak Speak Out
4-Year-Old Hospitalized Post Measles Infection Goes Home 36 Hours After Budesonide Treatment
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Hundreds of thousands of nosocomial infections happen every year and no one even blinks. Hospitals apparently get a pass for letting people die from diseases they acquired from the hospitals and then died from them!No justice! To go as a patient into a hospital is taking your life in your hands. Patients Beware!